Neurology: Not only "indifferent"-indifference may mean a disease in the brain!

Neuropsychiatric symptoms (NPS) are very common in the cognitive function spectrum of the elderly.
In the development of cognitive ability, it affects half of patients with mild cognitive impairment and almost all patients with dementia
.
Neuropsychiatric symptoms have predictive value in predicting accelerated disease progression and functional decline

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Neuropsychiatric symptoms have predictive value in predicting accelerated disease progression and functional decline

Apathy, defined as reduced motivation and goal-oriented behavior, is the most common neuropsychiatric symptom in the subtype of dementia, and is usually described as a manifestation of "indifferent

Apathy is widespread in cerebral small vessel disease (CSVD), which is a vascular disease that damages white matter and causes stroke, cognitive decline, and disability

.

Apathy is widespread in cerebral small vessel disease (CSVD), which is a vascular disease that damages white matter and causes stroke, cognitive decline, and disability

First, the researchers explored whether lacunar infarctions (LIs) and white matter hyperintensity (WMH) are related to apathy caused by network interruptions
.
Next, the whole brain networks of apathetic patients and depression patients are compared to find out the characteristics of network impairment in apathetic patients

.

331 CSVD patients from Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort Study (RUN DMC) completed the measurement of apathy and depression, and underwent structural MRI
.
The results show that apathy is related to depression, cognition, education, WMH, LIs, and brain network measurements, and all network measurements are highly correlated (r> 0.

85)

Apathy is related to depression, cognition, education, WMH, LIs and brain network measurements, and all network measurements are highly correlated (r> 0.

Intermediary analysis results

Intermediary analysis results

The path analysis model shows that after controlling WMH volume and LIs at the same time, the relationship between overall efficiency (representing the intermediate effect of network integrity on CSVD and indifference) and indifference (β = 0.

304, p <0.

It suggests that network interruption plays an intermediary role between indifference and CSVD marking

The overall efficiency is still an indifferent predictor (β = 0.

Whole brain network measurement one-way ANCOVAs comparison results

Whole brain network measurement one-way ANCOVAs comparison results

Further analysis showed that compared with all other groups, apathetic patients were impaired in the whole brain measurement of network density and efficiency
.
Regional network analysis of the subgroups and the entire sample showed that apathy is related to the damage to the connection between the pre-exercise area and the cingulate area
.

Further analysis showed that compared with all other groups, apathetic patients were impaired in the whole brain measurement of network density and efficiency
.
Further analysis showed that compared with all other groups, apathetic patients were impaired in the whole brain measurement of network density and efficiency
.

In summary, indifference, not depression, is related to damage to the white matter tracts of cerebrovascular disease
.
Sub-network analysis suggests that apathy may be driven by damage to the white matter tracts of action-initiated and effort-based decision-making
.

In summary, indifference, not depression, is related to damage to the white matter tracts of cerebrovascular disease
.
Sub-network analysis suggests that apathy may be driven by damage to the white matter tracts of action-initiated and effort-based decision-making
.
In summary, indifference, not depression, is related to damage to the white matter tracts of cerebrovascular disease
.
Sub-network analysis suggests that apathy may be driven by damage to the white matter tracts of action-initiated and effort-based decision-making
.

 

references:

Apathy is associated with large-scale white matter network disruption in small vessel disease.
Neurology®2019;92:e1157-e1167.
doi:10.
1212/WNL.
0000000000007095

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